Minimally invasive coronary surgery: fad or future?

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7125.88 (Published 10 January 1998) Cite this as: BMJ 1998;316:88

This promising technique needs testing in randomised trials

  1. Massimo A Mariani (M.Mariani@thorax.azg.nl), Cardiac surgeona,
  2. Piet W Boonstra, Cardiac surgeona,
  3. Jan G Grandjean, Cardiac surgeona
  1. a Thorax Centre, University Hospital, PO Box 30.001, 9700 RB Groningen, Netherlands

    Minimally invasive coronary surgery is a radical modification of conventional coronary artery bypass surgery and is performed through a small thoracotomy, the surgeon anastomosing the left internal mammary artery to the left anterior descending artery without the use of either cardiopulmonary bypass or cardioplegic arrest.1 2 Since its description in 1994,1 few new techniques in cardiac surgery have aroused such interest or had such a rapid diffusion. Initial enthusiasm, however, has been followed by a wave of scepticism. As the indications for minimally invasive coronary surgery become clearer it is time for a calmer apraisal.

    Initial enthusiasm for the technique arose because it avoided the need for cardiopulmonary bypass3 and provided an opportunity to reduce the use of health- care resources. Inevitably there were early failures, and some investigators began to highlight …

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